Septic Arthritis Lecture Powerpoint Flashcards
Predisposing factors for septic arthritis (6)
- diabetes
- RA
- prosthetic joint
- skin infection
- IV drug use
- intraarticular steroid injection
Pathophysiology of septic arthritis
- Bacterial products such as exo and endotoxins cause inflammation
- cytokines cause local inflammation as well as systemic effect such as fever and malaise and leukocytosis
- joint fluid should normally be sterile
Septic arthritis is usuallys econdary to ____ spread
Hematogenous spread from distant organs
Most common etiologic agent of septic arthritis in all age groups
Staph aureus
Clinical manifestations of septic arthritis
- acutely inflamed monoarticular joint, usually swollen warm and erythematous
- severe pain often with fever and chills
- knee involved in more than 50% of cases
Diagnosis of septic arthritis (1)
-synovial fluid aspiration followed by gram stain, bacterial culture, WBC count and diff, TB and fungal culture, SF crystal analysis to differentiate from gout/pseudogout, blood cultures
What type of synovial fluid is seen in septic arthritis
Class III
Differential diagnosis of septic arthritis (4)
- gout and pseudogout
- reactive arthritis
- flare of RA
- lyme dz
Treatment of septic arthritis (1)
-Antibiotics based on clinical presentation, gram stain, and culture,
Septic arthritis in children complication
Complications with growth plate can occur causing failure of bone to grow to full length
CDAI score
Outcome measure that can be tracked over course of RA and treatment, easy formula based on patient global + physician global + tender joints + swollen joints, with remission being <2.8, low dz activity 2.8-10, moderate 10-22, and high >22
Whipples disease
Bacterial infection causing chronic joint pain, chronic diarrhea that can be bloody, weight loss sometimes, and steatorrhea treated with long term antibiotics
List the common enteropathic arthropathies (4) - they often produce a seronegative polyarthritis
- Ulcerative colitis
- Crohns
- postenteric reactive arthritis
- whipples disease
Plant thorn synovitis
Uncommon monoarthritis caused by plant thorns which penetrate the joint capsule, often affects the small joints of hand or wrist, treated by surgical removal
Diffuse idiopathic skeletal hyperostosis
Flowing calcification of at least 4 vertebral levels, relative preservation of intervertebral disk and most often involving the anterior longitudinal ligament
